Assessing the predictive accuracy of QUICKI as a surrogate index for insulin sensitivity using a calibration model
Assessing the predictive accuracy of QUICKI as a surrogate index for insulin sensitivity using a calibration model
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DOI：
10.2337/diabetes.54.7.1914
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发表时间：
2005-07-01
期刊：
影响因子：
7.7
通讯作者：
Quon, MJ
中科院分区：
文献类型：
--
作者：
Chen, H;Sullivan, G;Quon, MJ
定量胰岛素敏感性检查指数（QUICKI）与胰岛素敏感性葡萄糖钳夹指数（SIClamp）具有良好的线性相关性，优于许多其他替代指数。然而，替代物和参考标准之间的相关性可以随着组群中受试者之间的变异性增加而改善（即，具有增加的值范围）。相关性可能是优秀的，即使当预测的参考值的替代品是穷人。因此，评价QUICKI准确预测参考葡萄糖钳夹法测定的胰岛素敏感性的能力非常重要。在本研究中，我们使用校准模型来比较QUICKI和其他简单替代物预测SIClamp的能力。预测精度通过预测均方根误差以及更稳健的留一交叉验证型预测均方根误差（CVPE）进行评估。基于从非肥胖、肥胖、2型糖尿病和高血压受试者中获得的116个葡萄糖钳夹试验数据，我们发现QUICKI和log（稳态模型评估[HOMA]）在预测SIClamp方面均表现出色（CVPE分别为1.45和1.51），显著优于HOMA、1/HOMA和空腹胰岛素（CVPE分别= 3.17，P < 0.001; 1.67，P < 0.02;和2.85，P < 0.001）。QUICKI和log（HOMA）也具有残差的最大分布（测量的SIClamp -预测的SIClamp）。在一个也接受了频繁采样的静脉内葡萄糖耐量试验和最小模型分析的受试者亚组（n = 78）中，QUICKI在预测SIClamp方面显著优于胰岛素敏感性最小模型指数（SIMM）（CVPE = 1.54 vs. 1.98，P = 0.001）。我们得出结论，QUICKI和log（HOMA）是确定人类胰岛素敏感性的最准确的替代指标之一。
The quantitative insulin-sensitivity check index (QUICKI) has an excellent linear correlation with the glucose clamp index of insulin sensitivity (SIClamp) that is better than that of many other surrogate indexes. However, correlation between a surrogate and reference standard may improve as variability between subjects in a cohort increases (i.e., with an increased range of values). Correlation may be excellent even when prediction of reference values by the surrogate is poor. Thus, it is important to evaluate the ability of QUICKI to accurately predict insulin sensitivity as determined by the reference glucose clamp method. In the present study, we used a calibration model to compare the ability of QUICKI and other simple surrogates to predict SIClamp. Predictive accuracy was evaluated by both root mean squared error of prediction as well as a more robust leave-one-out cross-validation-type root mean squared error of prediction (CVPE). Based on data from 116 glucose clamps obtained from nonobese, obese, type 2 diabetic, and hypertensive subjects, we found that QUICKI and log (homeostasis model assessment [HOMA]) were both excellent at predicting SIClamp (CVPE = 1.45 and 1.51, respectively) and significantly better than HOMA, 1/HOMA, and fasting insulin (CVPE = 3.17, P < 0.001; 1.67, P < 0.02; and 2.85, P < 0.001, respectively). QUICKI and log(HOMA) also had the narrowest distribution of residuals (measured SIClamp - predicted SIClamp). In a subset of subjects (n = 78) who also underwent a frequently sampled intravenous glucose tolerance test with minimal model analysis, QUICKI was significantly better than the minimal model index of insulin sensitivity (SIMM) at predicting SIClamp (CVPE = 1.54 vs. 1.98, P = 0.001). We conclude that QUICKI and log(HOMA) are among the most accurate surrogate indexes for determining insulin sensitivity in humans.